538 



Tuberculosis. 



lierent, producing grape or cauliflower-like masses (Fig. 81). 

 These growths may be present in enormous numbers on the 

 serous membranes, and the membrane itself may be thickened 

 to the extent of several centimeters. This is especially common 

 in the folds of the pericardium which are frequently found in 

 a state of adhesion, surrounding the heart in the form of a 

 dense fibrous capsule several centimeters in thickness and 



81. Tuberculosis. Pearl Disease of the Pleura. 



riddled with cheesy or mortar-like foci (so called armoured 

 heart — Panzerherz). This capsule is either sharply separated 

 from the heart, or white connective tissue septa may pass from 

 it into the substance of its muscular structure. The heart sub- 

 stance itself may contain cheesy foci which may also be present 

 where the epicardium is intact (embolism). Tuberculosis of 

 the endocardium or the valves is very rare (Bergeon found 

 miliar}^ tubercles on the valves and on the intima of the aorta). 



